WO2021078628A1

WO2021078628A1 - Gum healing abutment for a dental implant

Info

Publication number: WO2021078628A1
Application number: PCT/EP2020/079073
Authority: WO
Inventors: Jacques CAMPS
Original assignee: Creadent Montauban
Priority date: 2019-10-23
Filing date: 2020-10-15
Publication date: 2021-04-29
Also published as: EP4048190A1; FR3102354B1; JP2022553660A; FR3102354A1; CA3153876A1; CN114599312B; CN114599312A; US20240148477A1

Abstract

A healing abutment (P) configured to be provided in an implant (5) prior to fitting a prosthetic tooth and comprising a leg (1) and a head (2) which are aligned along an axis Z and connected by means of a tensioning screw (4), the leg (1) comprising a lower leg portion configured to cooperate with the implant (5), the head (2) comprising a lower head portion configured to cooperate with an upper portion of the leg, the healing abutment (P) comprising a reference member (3) which defines a reference point (X, Y, Z) and is configured to cooperate with the leg (1) in order to define a plurality of basic reference point (X, Y, Z) positions and is movably mounted relative to an upper portion of the head (21) having a predetermined shape in order to allow the selection of at least one optimum basic position from the plurality of basic positions.

Description

DESCRIPTION

Title of the invention: GUM HEALING PILLAR FOR AN IMPLANT

DENTAL

TECHNICAL AREA

[0001] The present invention relates to the field of dental implantology and more particularly relates to a pillar for healing the gum around an implant for placing a prosthetic tooth.

[0002] In known manner, a patient can have an implant system fitted in place of a missing tooth, namely an artificial tooth allowing him to regain normal chewing and aesthetic dentition.

In known manner, an implant system comprises an implant configured to be fixed in the jawbone of the patient, a prosthetic tooth similar in appearance to the visible part of the missing tooth and a prosthetic abutment ensuring the connection between the implant and prosthetic tooth.

[0004] In practice, the implant comprises a threaded outer cylindrical wall so as to be screwed to the patient's jawbone and a threaded inner cylindrical wall forming an implant housing. The prosthetic abutment in turn includes a threaded rod configured to be screwed into the implant housing. In other words, the threaded rod and the internal threaded cylindrical wall cooperate by screwing to mount the prosthetic abutment in the implant. The prosthetic tooth is screwed or sealed to the prosthetic abutment, with or without the aid of a tightening screw.

In known manner, the implant system is placed in several stages. First, a drilling is done in the gum and in the jawbone at the level of the missing tooth, where the implant is inserted. Secondly, an impression of the patient's mouth is taken in order to make a prosthetic tooth of a shape and size adapted to those of the missing tooth. The prosthetic abutment and the prosthetic tooth are then placed in a third step.

The time between the placement of the implant and the taking of impressions is approximately three to six months depending on the patient in order to allow healing of the gum around the implant as well as the immobilization of the implant within the jawbone, known to those skilled in the art under the term “osseointegration”. In practice, when placing the implant, a healing screw is inserted into the implant housing. This comprises a threaded rod similar to that of the prosthetic abutment which makes it possible to avoid both the deposit of food residues in the implant housing and the covering by the gum of the thread of its internal tapped cylindrical wall, and a flat head mounted on the threaded rod, promoting healing of the gum around the implant. In certain cases, for example when the patient is a smoker or following a bone graft, a cover screw is inserted in order to promote osseointegration, replaced by the healing screw thereafter. A temporary prosthetic tooth can be fitted to the cover screw and the healing screw for aesthetic purposes.

When taking impressions, whether physical or optical, the healing screw must be removed in order to precisely measure the available space left by the missing tooth and the position of the implant in this available space . In the case of a physical impression, a cast of the patient's mouth is made. In the case of optical impression taking, a transfer is inserted into the implant housing and a scanner measures the available space and the relative position of the transfer in the available space, giving access to the position of the implant. implant. The healing screw is then reinserted and removed to place the prosthetic abutment and prosthetic tooth.

All these manipulations of the healing screw are time consuming, unpleasant for the patient and increase the risk of inflammation of the gums and jawbone at the implant level, known to those skilled in the art under the term of "peri-implantitis". Peri-implantitis results in retraction of the gum tissue at the level of the implant, which may leave part of the implant visible, which is painful for the patient, unsightly and may require further intervention.

[0010] Furthermore, the healing screw has the drawback of causing healing of the gum along an unnatural circular gingival contour, so that the emergence profile of the prosthetic tooth once placed is not natural and therefore not very aesthetic. In other words, the interface between the prosthetic tooth and the healed gum tissue does not present a harmonious concave profile. In addition, food can become lodged at the interface between the prosthetic tooth and the gum tissue, which can lead to infection or other inconvenience.

To overcome these drawbacks, it is known in the prior art to replace the healing screw with a healing abutment comprising a head comprising a head housing in which is inserted a clamping screw connecting the head to the implant. This head has a conical shape chosen to allow healing of the gum according to a gingival contour adapted to the prosthetic tooth that will be placed. In addition, this healing abutment comes in four shapes referenced by a color, depending on whether the missing tooth is an incisor, canine, premolar or molar. When taking optical impressions, this healing abutment replaces the transfer and therefore does not need to be removed.

Another healing pillar comprising a foot configured to be inserted into the housing of the implant and a head of diameter similar to the prosthetic tooth allowing healing of the gum along a contour is also known from patent application WO2014158534A1. adapted gingival. The foot and the head respectively comprise a through cavity of the foot and a through cavity of the head in the extension of the implant housing, in which is inserted a tightening screw to connect the implant, the foot and the head and thus form the healing pillar. In addition, the head has upper notches, the arrangement and shape of which indicate the size of the head and its position relative to the implant. Sixteen different notch combinations are suggested. When taking optical impressions, this healing abutment thus replaces the transfer.

In the prior art, the patent application WO2017085288A1 also teaches a healing abutment whose head has an upper surface making it possible to replace the transfer during the taking of impressions, thanks to an asymmetrical shape with an edge which defines an oriented reference.

These two healing pillars, however, have two notable drawbacks. On the one hand, their angular position relative to the axis of the implant is determined in an imprecise manner, which has the consequence that the prosthetic tooth does not adapt perfectly to the available space and to the implant. . The assembly of the prosthetic tooth is then difficult, particularly in the case of a drilling in the gingiva off-center with respect to the available space, the prosthetic tooth in this case having a cantilever profile, which is little aesthetic and can lead to food becoming lodged at the interface between the prosthetic tooth and the gum, as explained previously.

On the other hand, to perform the transfer of optical impressions and thus determine the shape of the final tooth, it is necessary to use business software capable of reading the color code or the notches of the healing abutment. This has many drawbacks given that professionals must equip themselves with specific business software, that is to say where the information corresponding to each color or each notch has been implemented, as well as a large range of pillars of healing.

[0016] The present invention proposes to eliminate at least some of the drawbacks mentioned.

PRESENTATION OF THE INVENTION The invention relates to a healing abutment configured to be mounted in an implant before the placement of a prosthetic tooth, the healing abutment comprising a foot and a head which are aligned along a Z axis and connected by a screw. clamping extending along the Z axis, the foot comprising a lower part of the foot configured to cooperate with the implant and an upper part of the foot, the head comprising a lower part of the head configured to cooperate with the upper part of the foot, so as to mount the head on the foot, and an upper part of the head having a determined shape.

The invention is remarkable in that the healing pillar comprises at least one reference member defining a mark oriented along at least two dimensions and configured to cooperate with the foot in order to define a plurality of elementary positions of the mark oriented by in relation to said foot along the Z axis, said reference member being mounted so as to be movable relative to the upper part of the head in order to make it possible to select at least one optimum elementary position from among the plurality of elementary positions as a function of the determined shape of said upper head portion.

[0019] Advantageously, the healing abutment does not need to be removed or manipulated when taking impressions to define the shape and size of the prosthetic tooth. The prosthetic tooth can in fact be defined thanks to the reference organ, mounted on the upper part of the head and therefore visible without any manipulation. The risk of peri-implantitis is thus reduced and the taking of impressions is less time-consuming and more pleasant for the patient.

Preferably, the reference member defines a benchmark in three dimensions, so as to precisely define the shape and size of the prosthetic tooth.

[0021] According to one aspect of the invention, the reference member is mounted in an attached manner on the upper part of the head. Advantageously, a standard reference member can be mounted on a head of any size and shape. In other words, if the head has a size and a shape adapted to the missing tooth, such as an incisor or a canine, the reference organ is universal, which saves material and cost.

[0022] According to one aspect of the invention, the reference member comprises at least one neck comprising at least one projecting portion extending radially with respect to the Z axis, so as to define the mark. Advantageously, the projecting portion extends in an angular direction forming one of the axes of the mark. The mark is thus defined in a simple and easily readable manner by any physical or optical fingerprinting device.

Preferably, the protruding portion has a protruding radial length greater than 2mm, preferably greater than or equal to 3mm. Preferably, the radial length in protrusion is less than 5mm, in order to prevent the protruding portion protruding from the upper part of the head, causing discomfort to the patient.

According to a preferred aspect, the projecting portion is in the form of at least one reference finger extending radially with respect to the Z axis. A reference finger advantageously makes it possible to precisely define an angular direction forming one of the axes of the reference. Preferably, the protruding portion is in the form of at least two reference fingers, preferably three reference fingers, so as to define the reference more precisely, so as to manufacture a prosthetic tooth which perfectly matches. the patient's mouth. A small measurement uncertainty on the scale of a tooth can indeed lead to the manufacture of a tooth that does not fit into the patient's mouth.

According to one aspect of the invention, the reference member comprises at least one neck comprising at least one reduced portion extending radially with respect to the Z axis and comprising a reduced radial length of less than 3mm, preferably less than or equal to 2mm. Preferably, the reduced radial length is greater than 0.5mm. In practice, it frequently happens that the implant is not mounted in the center of the cavity formed by the missing tooth so that the head of the manufacturing system is mounted off-center with respect to the Z axis. The reduced portion may thus advantageously be positioned angularly so as not to project radially with respect to the head. Such a small portion thus makes it possible to increase the comfort of the patient and to facilitate its assembly.

Preferably, the reduced portion extends over an angular range around the Z axis greater than 90 °. Preferably, the angular range is greater than 150 °, more preferably greater than 180 °.

Preferably, the neck of the reference member extends in a plane transverse to the Z axis.

[0028] According to one aspect of the invention, the reference member comprises a through-Z axis reference cavity, within which the clamping screw extends. Advantageously, the reference organ is mounted integral with the healing abutment and does not need to be mounted and then removed when taking impressions.

According to another aspect of the invention, the upper part of the foot comprising at least a first interlocking member, the lower head part comprising at least one second interlocking member configured to cooperate with the first member of the interlocking so as to mount the head on the foot, the first interlocking member comprises at least eight radial teeth with respect to the Z axis and the second interlocking member comprises at least eight radial notches configured to cooperate with the radial teeth in order to define a plurality of elementary positions between the foot and the head with respect to the Z axis.

[0030] Advantageously, the angular positioning of the healing abutment relative to the implant is precise and thin, which allows easier placement of the healing abutment and a better aesthetic and functional rendering for the patient.

Preferably, the first interlocking member comprises at least twelve radial teeth, preferably at least eighteen radial teeth, preferably at least twenty-four radial teeth, for fine and precise angular positioning of the pillar. healing in relation to the implant.

Preferably, the second interlocking member comprises at least twelve radial notches, preferably at least eighteen radial notches, preferably at least twenty-four radial notches, for fine and precise angular positioning of the pillar of healing in relation to the implant.

[0033] In one aspect, the head includes a through Z axis head cavity, within which the clamping screw extends. Such a head thus has a dual function of temporary prosthetic tooth. No provisional prosthetic tooth is thus mounted on the healing abutment. The healing abutment is thus less bulky, less expensive and easier to handle.

[0034] According to one aspect, the head forms a prosthetic healing tooth configured to have substantially the shape and size of the prosthetic tooth to be placed, for an aesthetic and functional rendering for the patient throughout the healing period.

According to another aspect of the invention, the foot comprises at least a third interlocking member and the reference member comprises an annular body of axis Z comprising at least a fourth interlocking member configured to cooperate with the third interlocking member in order to define a plurality of elementary positions between the foot and the reference member with respect to the Z axis. Such a reference member occupies a small volume and its angular positioning with respect to the foot, and therefore to the implant, is precise and fine. The determination of the shape and size of the prosthetic tooth during impression transfer is thus precise.

According to one aspect, the third interlocking member comprises at least three axial teeth relative to the Z axis. Preferably, the fourth interlocking member comprises at least three axial notches configured to cooperate with the axial teeth in order to define a plurality of elementary positions between the foot and the reference member with respect to the Z axis. Preferably, the third interlocking member comprises three axial teeth relative to the Z axis. Preferably, the fourth interlocking member comprises three axial notches. Advantageously, the positioning of the reference member and more precisely of one of its reference fingers is facilitated.

The invention also relates to an assembly of an implant and a healing abutment as presented above, the implant comprising a fixing end configured to be fixed to the jawbone of a patient and an end gingival configured to extend into the patient's gum tissue and comprising an implant housing comprising an internal thread, the lower foot portion of the healing abutment being mounted in the implant housing and the healing abutment clamping screw cooperating with the tapping of the implant housing.

PRESENTATION OF FIGURES

The invention will be better understood on reading the description which follows, given solely by way of example, and referring to the accompanying drawings given by way of non-limiting examples, in which identical references are given to similar objects and on which:

[0040] Figure 1 is a schematic perspective representation of the healing abutment according to the invention;

Figure 2A and

[0042] Figure 2B are perspective diagrammatic representations of the foot of the healing abutment according to the invention;

[0043] Figure 2C is a schematic perspective representation of the foot of the healing abutment according to an alternative form of the invention;

Figure 3A and

[0045] Figure 3B are perspective schematic representations of the head of the healing abutment according to the invention;

Figure 4A and

FIG. 4B are diagrammatic perspective representations of the reference organ of the healing abutment according to the invention; Figure 4C is a schematic representation in cross section of the neck of the reference member according to the invention;

[0049] Figure 4D is a schematic cross-sectional representation of the neck of the reference member mounted off-center with respect to the Z axis according to an alternative embodiment of the invention;

[0050] FIG. 4E is a schematic perspective representation of the reference organ of the healing abutment according to an alternative form of the invention;

[0051] Figure 5 is a schematic perspective representation of the tightening screw of the healing abutment according to the invention;

Figure 6A and

[0053] FIG. 6B are perspective diagrammatic representations of the method of mounting the healing abutment according to the invention; and

[0054] Figure 7A and

[0055] Figure 7B are schematic representations in longitudinal section of the healing abutment according to the invention in a mounted position centered and off-center relative to the Z axis respectively.

It should be noted that the figures set out the invention in detail to implement the invention, said figures can of course be used to better define the invention if necessary.

DETAILED DESCRIPTION OF THE INVENTION

In known manner, an implant system comprises an implant configured to be fixed in the jawbone of a patient in place of a missing tooth, a prosthetic tooth similar in appearance to the visible part of the tooth missing and a prosthetic abutment ensuring the connection between the implant and the prosthetic tooth.

In known manner, an implant comprises a fixation end configured to be fixed to the jawbone of the patient and a gingival end configured to extend into the gum of the patient and comprising an implant housing, configured to cooperate with the prosthetic abutment. More precisely, the fixing end comprises an external thread so as to be screwed into the jawbone of the patient. The gingival end for its part comprises an implant housing comprising an internal thread. A healing abutment according to the invention configured to be mounted in an implant, before placing the prosthetic tooth and the prosthetic abutment, is described below.

According to the invention, with reference to Figure 1, the healing pillar P comprises a foot 1 and a head 2 which are aligned along a vertical axis Z and connected by a clamping screw 4 extending along an axis Z. More precisely, the foot 1 comprises a lower part of the foot configured to cooperate with the implant 5 and an upper part of the foot configured to cooperate with the head 2. The head 2 in turn comprises a lower part of the head configured to. cooperate with the upper part of the foot so as to mount the head 2 on the foot 1 and an upper part of the head having a determined shape.

According to the invention, still with reference to FIG. 1, the healing abutment P further comprises a reference member 3 defining a marker oriented X, Y, Z in several dimensions. The reference member 3 is on the one hand configured to cooperate with the foot 1 in order to define a plurality of elementary positions of the reference mark oriented X, Y, Z with respect to the foot 1 along the Z axis and on the other hand mounted on the upper part of the head in order to make it possible to select at least one optimal elementary position from among the plurality of elementary positions as a function of the determined shape of the upper part of the head. Such a healing abutment P according to the invention thus has the advantage of not having to be removed or manipulated when taking impressions to define the shape and size of the prosthetic tooth, whether the impression is physical. or optical. The prosthetic tooth is in fact only defined from the reference organ 3, visible without any manipulation, which saves time and comfort for the patient while also reducing the risk of peri-implantitis.

The following describes successively the structural and functional aspects of the foot 1, of the head 2, of the reference member 3 and of the clamping screw 4. Note that throughout the present application for patent, the terms "interior" and "exterior" are defined radially with respect to the Z axis and the terms "lower" and "upper" are defined with respect to the vertical axis Z, oriented from the foot 1 to the head 2 .

Referring to Figures 2A and 2B, the foot 1 extends along the Z axis and comprises a lower leg portion 10, an upper leg portion 11 and a foot cavity 12 vertically passing through the lower leg portion 10 and the upper leg part 11 for the passage of the clamping screw 4. In the example of Figures 2A and 2B, the lower leg part 10 and the upper leg part 11 are separated by a crown 13 of axis Z. The crown 13 extends in radial projection with respect to the axis Z so as to serve as an axial support for the head 2, that is to say as a stop, and to allow its correct axial positioning according to the axis Z. If this crown 13 has the advantage of being compact, it goes without saying that it could be replaced by any support element or even that the lower part of the leg 10 and the upper part of the leg 11 could be in direct contact. In this example, the crown 13 has a flat upper surface to cooperate with the head 2 in a stable manner. Preferably, the crown 13 has a frustoconical lower surface, increasing from bottom to top along the Z axis, so as to adapt to the shape of the gum.

Preferably, as illustrated in Figures 2A and 2B, the lower foot portion 10 comprises a foot rod 14 having a surface of revolution of axis Z which is threaded, as well as a connecting ring 15 mounted to the above the foot rod 14 relative to the Z axis, of polygonal shape, defining in this example eight faces. By means of the foot rod 14 and the connecting ring 15, the lower part of the foot 10 is configured to provide the connection between the healing abutment P and the implant 5. More precisely, the foot rod 14 is configured for cooperate with the thread of the implant housing so as to screw the foot 1 onto the implant 5 while the connecting ring 15 is configured to cooperate with a polygonal outer wall of the implant housing so as to prevent unscrewing of the implant. foot 1 relative to the implant 5, known to those skilled in the art under the term “anti-rotation system”. In the example of Figures 2A and 2B, the connecting ring 15 has eight faces, but it goes without saying that the number of faces could be different. Furthermore, it goes without saying that the connecting ring 15 could be any anti-rotation system, or even that there could be no anti-rotation system.

The upper part of the foot 11 comprises for its part a first interlocking member 17 comprising a plurality of radial teeth with respect to the Z axis configured to cooperate with a second interlocking member of the head 2, presenting itself in the form of radial notches. Advantageously, the first interlocking member 17 and the second interlocking member make it possible to angularly adjust the mounting of the head 2 on the foot 1. In other words, the head 2 can be mounted in different possible elementary positions on the foot. 1. Such interlocking members 17 also play the role of an anti-rotation system, preventing any rotational movement between the foot 1 and the head 2 once mounted. In the example of Figures 2A and 2B, the number of radial teeth is twenty-four, offering fine angular adjustment. Advantageously, the head 2 can be positioned in twenty-four different elementary positions and thus adapt precisely to the available space left by the missing tooth in the patient's mouth. It goes without saying that the number of radial teeth could be lower, the fineness of the angular adjustment then being less, within the lower limit of eight radial teeth. The number of radial teeth could also be greater, however the gain provided would be hardly visible and would superfetorily increase the complexity of the first interlocking member 17. Moreover, in the example of FIGS. 2A and 2B, the radial teeth appear. in the form of triangular prisms of axis Z, allowing easy mounting of the head 2 on the foot 1, but it goes without saying that the radial teeth could take a different shape, such as a cylindrical shape with a rectangular base. Preferably, still with reference to Figures 2A and 2B, the upper head part 11 further comprises a third interlocking member 16 mounted above the first interlocking member 17 along the Z axis and comprising axial teeth of axis Z so as to be able to mount the reference member 3 on the foot 1. The third interlocking member 16 also acts as an anti-rotation system, preventing any rotational movement between the reference member 3 and the foot 1. In the example of FIGS. 2A and 2B, the number of axial teeth amounts to four, offering four possible elementary positions for the reference member 3. It goes without saying that the number of axial teeth could be different, preferably. equal to three to facilitate the positioning of the reference member 3, as illustrated in FIG. 2C. Furthermore, in the example of Figures 2A and 2B, the axial teeth are in the form of cylinders with a rectangular base of axis Z, allowing easy mounting of the head 2 on the foot 1, but it goes without saying that the axial teeth could take a different shape.

[0067] Thus, the foot 1 makes it possible to define precise angular orientations with respect to the implant 5, the head 2 and the reference organ 3.

The head 2 is described below with reference to Figures 3A and 3B. As illustrated in these two figures, the head 2 has a peripheral shape Z and comprises a lower head part 20, an upper head part 21 and a head cavity 23 passing through the lower head part 20 and the upper head part 21. for the passage of the clamping screw 4.

Preferably, as illustrated in Figures 3A and 3B, the lower head portion 20 comprises a conical outer wall configured to promote healing of the gum according to a concave profile around the conical outer wall, so that 'Once the prosthetic tooth is placed, the interface between the prosthetic tooth and the gum is natural and aesthetic. The taper of the outer wall of the lower part of the head 20 depends on the missing tooth to be replaced, depending on whether it is an incisor, a canine, a premolar or a molar. of examples. Preferably, the outer wall is in the continuity of the crown 13 of the foot 1.

[0070] According to a preferred aspect of the invention, the head 2 forms a prosthetic healing tooth configured to have substantially the shape of the prosthetic tooth to be placed. The addition of a temporary prosthetic tooth is therefore not necessary since the head 2 performs this function in addition to that of healing the gum. In addition, preferably, the upper part of the head 21 comprises a rounded peripheral edge 22 for aesthetic purposes and to prevent the edge from being sharp and from injuring the patient's mouth.

As described above, as illustrated in Figures 3A and 3B, the lower head part 20 comprises a second interlocking member 24 comprising a plurality radial notches. Such a second interlocking member 24 is configured to cooperate with the first interlocking member 17 of the foot 1, so as to mount the head 2 on the foot 1 and to prevent a relative rotational movement between said head 2 and said foot. 1. Preferably, the number of radial notches of the second interlocking member 24 is equal to that of the first interlocking member 17, for easy assembly. Also preferably, the shape of the radial notches is complementary to the shape of the radial teeth of the first interlocking member 17, for easy assembly. It goes without saying, however, that the number of radial notches of the second interlocking member 24 and their shape may not be complementary to the radial teeth of the first interlocking member 17.

The head 2 can thus be positioned ergonomically on the foot 1.

The reference member 3 is described below with reference to Figures 4A, 4B and 4C. As illustrated in the figures, the reference member 3 comprises a peripheral body 30 of axis Z, a neck 31 mounted on the body 30 and a reference cavity 32 of axis Z passing through the body 30 and the neck 31 for the passage of the clamping screw 4. The body 30 is configured to cooperate with the upper part of the foot 11. The neck 31 is for its part configured to be mounted on the upper part of the head 21 and define the reference mark X, Y, Z. The neck 31 extends in a plane transverse to the Z axis.

Advantageously, the cooperation of the body 30 and the upper part of the foot 11 makes it possible to link the angular positioning of the foot 1 to that of the reference member 3 and in particular to that of the neck 31 which is the part visible from the reference organ 3 once the healing abutment P has been mounted. Thus, the orientation of the mark X, Y, Z defined by the neck 31 is that of the foot 1, which avoids having to dismantle the healing abutment P when taking impressions. The mounting of the neck 31 on the upper part of the head 21 also makes it possible to define the angular position of the head 2 in the reference frame oriented X, Y, Z. The reference member 3 and the head 2 allow full cooperation determine the final prosthetic tooth. The reference cavity 32 also makes it possible to secure the reference organ 3 to the healing abutment P.

As illustrated in Figures 4A and 4B, the body 30 is cylindrical of circular section and has a diameter smaller than that of the head cavity 23 so as to be able to be inserted into said head cavity 23. Furthermore, the body 30 comprises a fourth interlocking member 33 configured to cooperate with the third interlocking member 16 of the foot 1, so as to mount the reference member 3 on the foot 1 and to prevent any relative rotational movement between said member reference 3 and said foot 1. Preferably, the fourth interlocking member 33 comprises axial notches. The number of axial notches of the fourth interlocking member 33 is equal to that of axial teeth of the third interlocking member 16, for easy assembly. In the example of FIG. 4B, the fourth interlocking member 33 thus comprises four axial notches to cooperate with the fourth interlocking member 16 of FIG. 2B. In the example of FIG. 4E, the fourth interlocking member 33 for its part comprises three axial notches to cooperate with the fourth interlocking member 16 of FIG. 2C. Also preferably, the shape of the axial notches is complementary to the axial teeth of the third engagement member 16, for easy assembly. It goes without saying, however, that the number of axial notches of the fourth interlocking member 33 as well as their shape may not be complementary to the axial teeth of the third interlocking member 16.

As illustrated in Figure 4C, the neck 31 comprises a projecting portion 37 extending radially relative to the Z axis and whose radial direction defines one of the directions of the reference mark X, Y, Z. From preferably, the protruding portion 37 extends over a radial protruding length L37 greater than 2mm, preferably greater than or equal to 3mm so as to indirectly indicate an orientation of the foot 1. The radial protruding length L37 is less than 5mm , so as to limit the bulk.

Such a projecting radial length L37 also makes it possible to prevent the projecting portion 37 from extending projecting relative to the head 2, which would cause discomfort for the patient and would complicate the assembly of the manufacturing pillar. P. In the example of FIG. 4C, the projecting portion 37 is aligned axially with one of the axial notches of the fourth interlocking member 33 for the sake of simplicity to define the reference mark X, Y, Z but it goes from itself that might not be the case.

In the example of Figure 4C, the neck 31 has three protruding portions 37, 39A, 39B each aligned with an axial notch of the fourth interlocking member 33. In practice, a single protruding portion 37 is sufficient for define the reference X, Y, Z, but the other protruding portions 39A, 39B make it possible to define the reference X, Y, Z with more finesse, in order to be able to determine the prosthetic tooth as precisely as possible. It goes without saying that the number of protruding portions is any, although a number greater than 3 would increase the bulk unnecessarily. In this example, each of the protruding portions 37, 39A, 39B also has a different protruding radial length L37 in order to be able to simply distinguish the protruding portion 37 from the others. However, it goes without saying that the protruding portions 37, 39A, 39B could have the same radial protruding length L37.

More specifically, the projecting portions 37, 39A, 39B of the neck 31 are in the form of reference fingers 34, 35, 36, preferably rounded at their end so as not to interfere with the patient to the touch. Such a shape advantageously makes it possible to simply define a radial direction, however it goes without saying that the projecting portions 37, 39A, 39B could have any different shape. In particular, the neck 31 could have a polygonal section of which the tops form the projecting portions 37, 39A, 39B. The number of vertices could be equal to the number of axial notches of the fourth interlocking member 33. The projecting portions 37, 39A, 39B could also have a different shape from each other in order to distinguish them.

In the example of Figure 4C, the neck 31 further comprises a reduced portion 38 extending radially relative to the Z axis. The reduced portion 38 is advantageously configured to reduce the size of the member. reference 3 over a given angular range. In practice, as illustrated in Figure 4D, it happens that the implant is not positioned in the center of the space left by the missing tooth. In this case, the head 2 extends off-center relative to the Z axis, that is to say that the head cavity 23 is off-center relative to the head 2. The reference member 3 can in this case be mounted angularly so that the reduced portion 38 is advantageously located where the radial distance separating the head cavity 32 from the outer walls of the upper head part 21 is the smallest.

Thanks to the reduced portion 38, the reference member 3 does not protrude from the head 2, even if the head 2 is off-center with respect to the Z axis.

Preferably, as illustrated in Figures 4C and 4D, the reduced portion 38 has a reduced radial length L38 reduced less than 3mm, preferably less than or equal to 2mm, in order to be effective even in the case of a pronounced off-center. Preferably, the reduced radial length L38 is greater than 0.5mm. Also preferably, the reduced portion 38 extends over an angular range a38 around the Z axis greater than 90 °, preferably greater than 150 °, more preferably still greater than 180 °, in order to be effective even in the case of 'a pronounced decentering.

The clamping screw 4 is described below with reference to FIG. 5. With reference to FIG. 5, the clamping screw 4 comprises a rod 40 of axis Z and a screw head 41 mounted on the rod 40. The rod 40 has a diameter configured to be less than that of the foot cavity 12, the head cavity 23, the reference cavity 32 and the implant housing. Thus the rod 40 is configured to be inserted into the foot cavity 12, the head cavity 23, the reference cavity 32 and the implant housing, so as to mount the healing abutment P on the implant.

Preferably, as illustrated in Figure 5, the rod 40 comprises a first threaded rod portion 42 configured to be screwed into the implant housing, a second rod portion 43 configured to extend into the lower portion. head 10, a third shank portion 44 of greater diameter than the inner diameter of the crown 13 of the foot 1 and configured to extend into the upper head portion 11 and a fourth shank portion 45 configured to extend into the head cavity 23 and in the reference cavity 32. However, it goes without saying that the rod 40 could include only a single part of rod or a selection of the aforementioned parts.

Preferably, as illustrated in Figure 5, the screw head 41 is flat so as to limit the size of the reference member 3 and comprises a head cavity 46 configured to receive a tool, such as a screwdriver, so as to screw the clamping screw 4 into the implant housing and tighten the assembly.

A method for mounting the healing abutment P according to the invention is described below, with reference to Figures 6A and 6B, which comprises four successive mounting steps detailed below.

During the first assembly step, the foot 1 is inserted into the implant housing by a longitudinal translational movement T1 relative to the Z axis then the foot rod 14 is screwed into the housing of implant by a rotational movement R1 around the Z axis until the connecting ring 15 is locked in the implant housing by complementarity of shapes. At the end of the first assembly step, the foot 1 is fixedly mounted in the implant housing.

During the second assembly step, the head 2 is mounted on the foot 1 by a longitudinal T2 translational movement relative to the Z axis until the first interlocking member 17 and the second interlocking member 24 cooperate and the head 12 is in contact with the crown 13 of the foot 1. The angular orientation between the head 2 and the foot 1 is defined precisely. At the end of the second assembly step, as illustrated in FIG. 7A, the head 2 rests on the crown 13 and is mounted fixed radially and tangentially with respect to the Z axis on the foot 1. The head 2, on the other hand, is mounted free in longitudinal translation along Z with respect to the foot 1.

During the third assembly step, the reference member 3 is mounted on the head 2 by inserting the body 30 into the head cavity 23 in a longitudinal translational movement T3 until the third member interlocking 16 of the foot 1 and the fourth interlocking member 33 of the reference member 3 cooperate. The orientation of the neck 31 defining the oriented mark is made before the translational movement T3 so that the reference member 3 does not project from the head 2 during an off-center assembly, as shown. in Figure 7B. In the example of FIG. 7B, the reduced portion 38 is thus positioned angularly where the upper part of the head 21 has the smallest radial length. At the end of the third assembly step, as illustrated in Figures 7A and 7B, the reference member 3 is mounted fixed radially and tangentially with respect to the Z axis on the head 2 and mounted free in longitudinal translation along Z with respect to said head 2. The angular orientation between the reference member 3 and the foot 1 is defined precisely.

During the fourth assembly step, the clamping screw 4 is inserted successively in the reference cavity 32, in the head cavity 23, in the foot cavity 12 and in the implant housing by a movement longitudinal translation T4 with respect to the Z axis and then by a rotational movement R4 around the Z axis so as to screw the first rod portion 42 into the implant housing. The rotational movement R4 is stopped when the third rod portion 44 is resting on the crown 13. At the end of the fourth assembly step, as illustrated in FIGS. 7A and 7B, the clamping screw 4 locks the head 2. and the reference member 3 in the longitudinal direction with respect to the Z axis. Furthermore, the clamping screw 4 is fixedly mounted in the implant housing.

[0090] Thanks to the healing abutment according to the invention described above, the healing of the gum tissue takes place in a concave profile so that once the prosthetic tooth is in place, the result is natural and aesthetic. In addition, when taking impressions, the healing abutment P does not need to be removed, which avoids time-consuming and unpleasant handling for the patient and reduces the risk of peri-implantitis. In addition, the reference member 3 provides an X, Y, Z oriented mark readable by any scanner and the head 2 acts as a temporary prosthetic tooth, avoiding the addition of this part requiring further manipulation. By reading the mark defined by the reference member 3, the user quickly, directly and precisely determines the orientation of the foot 1, which makes it possible to form a final tooth which will be perfectly positionable. Finally, this healing abutment P has the advantage of allowing precise angular positioning of the head 2 in the available space left by the missing tooth.

Claims

1. Healing abutment (P) configured to be mounted in an implant (5) prior to the placement of a prosthetic tooth, the healing abutment (P) comprising a foot (1) and a head (2) which are aligned according to a Z axis and connected by a clamping screw (4) extending along the Z axis, the foot (1) comprising a lower part of the foot (10) configured to cooperate with the implant (5) and an upper part foot (11), the head (2) comprising a lower head portion (20) configured to cooperate with the upper foot portion (11), so as to mount the head (2) on the foot (1), and an upper part of the head (21) having a determined shape, said healing pillar (P) being characterized in that it comprises at least one reference member (3) defining an oriented reference mark (X, Y, Z) according to at least two dimensions and configured to cooperate with the foot (1) in order to define a plurality of elementary positions of the oriented frame (X, Y, Z) with respect to said foot ( 1) along the Z axis, said reference member (3) being movably mounted and attached relative to the upper part of the head (21) in order to make it possible to select at least one optimum elementary position from among the plurality of elementary positions depending on the determined shape of said upper part of the head (21).

2. Healing abutment (P) according to claim 1, wherein the reference member (3) comprises at least one neck (31) comprising at least one projecting portion (37) extending radially relative to the Z axis, so as to define the coordinate system (X, Y, Z).

3. Healing abutment (P) according to claim 2, wherein the protruding portion (37) is in the form of at least one reference finger (34, 35, 36) extending radially relative to the 'Z axis.

4. Healing abutment (P) according to one of claims 1 to 3, wherein the reference member (3) comprises at least one neck (31) comprising at least one reduced portion (38) extending radially through relative to the Z axis and comprising a reduced radial length (L38) less than 3mm, preferably less than or equal to 2mm.

5. Healing abutment (P) according to claim 4, wherein the reduced portion (38) extends over an angular range (a38) around the Z axis greater than 90 °, preferably greater than 150 °.

6. Healing abutment (P) according to one of claims 1 to 5, wherein the reference member (3) comprises a reference cavity (32) of through Z axis, within which extends the clamping screw (4).

7. Healing abutment (P) according to one of claims 1 to 6, the upper part of the foot (11) comprising at least a first interlocking member (17), the lower part of the head (20) comprising at least a second interlocking member (24) configured to cooperate with the first interlocking member (17) so as to mount the head (2) on the foot (1), the first interlocking member (17) comprising at least eight radial teeth with respect to the Z axis and the second interlocking member (24) comprises at least eight radial notches configured to cooperate with the radial teeth in order to define a plurality of relative angular positions between the foot (1) and the head (2) with respect to the Z axis.

8. Healing abutment (P) according to one of claims 1 to 7, wherein the head (2) comprises a head cavity (23) of through Z axis, within which extends the clamping screw. (4).

9. Set of an implant (5) and a healing abutment (P) according to one of the claims

1 to 8, the implant (5) comprising a fixation end configured to be fixed to the jawbone (7) of a patient and a gingival end configured to extend into the gum (6) of the patient and comprising an implant housing comprising a female thread, assembly in which the lower foot part (10) of the healing abutment (P) is mounted in the implant housing and the tightening screw (4) of the healing abutment (P) cooperates with the tapping of the implant housing.